Infection, Prevention and Control - Clostridioides difficile

What is Clostridioides difficile?

Clostridioides difficile (also known as C.diff) is a type of bacteria that is present in the bowel of 3% of healthy adults and up to 66% of healthy babies, where it causes no symptoms.

C.diff infection nearly always follows antibiotic treatment, but occasionally can occur without it.

The antibiotic treatment decreases the number of 'good germs' in your bowel and this allows the C.diff bacteria to increase in number and cause a C.diff infection.

Who’s at risk of developing a Clostridioides difficile infection?

You're more likely to get a C. diff infection if:

• you’re over 65 years
• you’re taking, or have recently taken, antibiotics
• you’re staying in hospital or a care home for a long time
• you have a weakened immune system-for example, from having a long-term condition like diabetes or kidney failure, or treatment like chemotherapy
• you’re taking a proton pump inhibitor (PPI), such as omeprazole, or other medicines that reduce stomach acid
• you’ve had C.diff infection in the past

What symptoms can Clostridium difficile cause?

C.diff may cause gastroenteritis (diarrhoea), stomach cramps and a raised temperature. Other symptoms may
include sickness, loss of appetite and in some cases severe inflammation of the bowel.

What will happen now?

You may be asked to move to a single room or designated area where staff will care for you wearing gloves and aprons and pay particular attention to hand washing with soap and water.

The doctor will review the medications that you are taking. This review may include either stopping certain medications and starting new antibiotics to treat the C.diff infection if required.

You will be advised to wash your hand regularly with soap and water, especially after using the toilet and prior to eating and drinking.

Can I still have visitors?

Yes. C.diff is not a risk to your family or friends if they are healthy.

Your visitors will be advised to undertake hand washing with soap and water as alcohol hand gel is not effective. This task should be undertaken on entering the ward and leaving your immediate bed area.

What about when I go home?

C.diff is not usually a risk to your family, including children or those who are pregnant. Your GP will be informed about your C.diff infection, and you should contact them if you have any concerns or if the symptoms return.

If you should need antibiotics for any reason when you go home, you should inform the doctor that you have had a C.diff infection.

If you are still symptomatic with diarrhea when you are going home consider the following:

• wash your hands regularly using soap and water
• clean the toilet and area around it with disinfectant after each use
• wash clothes and sheets with poo on separately from other washing at the highest possible temperature

What not to do:

• do not share towels and flannels
• do not share bars of soap
• do not take medicine to stop diarrhoea like loperamide because it can prevent the infection being cleared from your body (unless under medical advice)

What happens if I need to go into hospital again?

You should inform the staff of your previous C.diff infection. You are not a risk to the other patients if you are not having diarrhoea.